Fibroids: What Your Patients Need to Know

Fibroids, uterine growths made of muscle cells and connective tissue, may give your patients a great amount of concern when they first develop. It has been estimated that up to 80% of women develop fibroids by the time they are 50 years of age.¹

Uterine fibroids are noncancerous an overwhelming majority of the time, but even benign fibroids have the potential to cause pain and discomfort. They can also result in complications during pregnancy. Your patients may not know a great deal about fibroids, also known as myomas, leiomyomas, and fibromas.² What are some of the basics you can share with them?

Fibroid Risk Factors

Health care professionals don’t currently know the exact cause of uterine fibroids, though it has been suggested that genetics and levels of the hormones estrogen and progesterone may play a role.³ Despite this, there are a number of potential risk factors you can bring up to your patients. Pregnancy may be considered a risk factor, as hormone levels are higher at this time. Research has also suggested that Black women are more likely to develop fibroids, as well as to develop them at a younger age and at larger sizes.³

Other risk factors include:

• Family history of fibroids
• Obesity
• Diet high in red meat and low in vegetables
• Alcohol consumption

Fibroid Symptoms

Often, women who have fibroids don’t experience any symptoms at all.⁴ Symptoms that do appear may vary in severity. They include:

• Abdominal discomfort
• Pelvic pain
• Heavy periods
• Longer periods
• Frequent urination or difficulties emptying bladder
• Constipation
• Back pain

Patients should see a health care professional if these symptoms are particularly painful or severe.

Fibroid Diagnosis and Treatment

Fibroids are often initially spotted by physicians during routine pelvic exams. Once a clinician suspects fibroids, they can perform a number of tests to confirm it. This can include imaging tests such as an ultrasound, magnetic resonance imaging (MRI) scan, or a hysterosalpingogram. Procedures like a laparoscopy or hysteroscopy, both of which involve a scope incision, may also be needed to confirm the presence of fibroids.¹

The type of treatment patients receive will depend on factors like symptom severity and the size of the fibroid. As many women don’t experience symptoms, and cases of fibroids becoming cancerous are rare (estimated at less than 1 in 1000 cases¹), often it is recommended that they simply do watchful waiting.⁵

Patients who receive treatment may get medications, such as Gonadotropin-releasing hormone agonists that block estrogen and progesterone production, or an intrauterine device (IUD) that releases progestin to lessen heavy bleeding. Patients with large or multiple fibroids may require surgery. This can include noninvasive surgeries, such as focused ultrasound surgery, or something as significant as a hysterectomy, depending on the severity.

References

1. Uterine fibroids. Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/uterine-fibroids. Updated April 1, 2019. Accessed January 12, 2022.

2. Macon BL. Fibroids. https://www.healthline.com/health/uterine-fibroids. Updated July 17, 2020. Accessed January 12, 2020.

3. Uterine fibroids – symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288. September 16, 2021. Accessed January 13, 2020.

4. Fibroids. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-fibroids. Accessed January 13, 2022.

5. Uterine fibroids – diagnosis and treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294. September 16, 2021. Accessed January 13, 2020.

This article originally appeared on Clinical Advisor